Provider Demographics
NPI:1669409660
Name:SUGARMAN, SIGMUND (MD)
Entity type:Individual
Prefix:
First Name:SIGMUND
Middle Name:
Last Name:SUGARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 SMITH RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2787
Mailing Address - Country:US
Mailing Address - Phone:513-366-4000
Mailing Address - Fax:513-366-4001
Practice Address - Street 1:4700 SMITH RD
Practice Address - Street 2:SUITE L
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2787
Practice Address - Country:US
Practice Address - Phone:513-366-4000
Practice Address - Fax:513-366-4001
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-1148208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0356412Medicaid
KY64763253Medicaid
OH0276946Medicaid
KY64763253Medicaid
OH0276946Medicaid
OH1114950003Medicare NSC
OHA71393Medicare UPIN